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At home with meaning

Evaluation of an approach to improve (assistant) nurses’ knowledge, attitudes and skills in attuning to meaning in life of old clients.
Publication date: 01 April 2015

Homecare workers are confronted with situations and questions about meaning in life in their daily work with (their elderly clients, but they do not always know how to respond to those issues in an appropriate way. In this project, spiritual counsellors are introduced to coach (assistant) nurses in sensitivity and skills to attune to meaning in life of their clients. This study will evaluate the contribution of this approach to both care workers and their clients.

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Introduction

“What reason do I have to get out of bed today?" “Have I done right in my life?” People are looking for meaning in their life. Whenever clients ask these types of questions care workers are often at a loss for words.

District nurses and assistant nurses are daily confronted with questions about meaning in life of clients: They can see that someone is religious by the way a room has been decorated, they notice whether someone faces the day optimistically or not, they see their patients struggle with pain and loneliness. Clients ask their care providers questions about meaning in life and meaning of death. How can (assistant) nurses respond to major and minor questions of life of their clients?

In this project, spiritual counsellors will support (assistant) nurses of a homecare organisation (Laurens Thuiszorg) in order to help them become more sensitive to meaning in life issues and respond to clients more appropriately. They will also involve the client’s network and organisations involved in spiritual care in the district of the clients. The study will evaluate the benefit of this approach for both the (assistant) nurses and their elderly patients. The findings will be introduced into the curriculum of nursing education and used in practice.

Project description

Meaning in life is important: it contributes to health, welfare and quality of life. As people grow older, it may be a challenge to experience meaning in life. The elderly are struggling with questions like: “What was the use of my life?”, “Where, in this day and age, do I fit in?”, “What makes my day worth living?” and “How can I contribute to anything if I am dependent on care?" Nowadays, the elderly continue to live at home in their own environment for as long as possible. At home, spiritual care is less available than it was in the, former, assisted-living centres. (Assistant) nurses are often already familiar to the clients, including less accessible groups in society. Which role can they play in bridging this gap in spiritual care?

However, care professionals admit that they find it difficult to recognise meaning in life issues. They are able to identify the major themes – especially those related to end of life – but daily meaning is not easily recognised. They also find it difficult to attune to these needs. Which comments do clients appreciate or find appropriate? Care workers’ reactions are often based on their own personal and, therefore, widely differing habits and standards rather than taking into account their client's value system.

In this project, teams of Laurens Thuiszorg will be coached in recognising elderly’s quests for meaning and becoming more skilled in attuning to their perspectives on meaning in the care relationship. An inventory of the organisations involved in spiritual care in both the neighbourhood and the city will also be made. They will be asked for their involvement. The coaching will depart from the care workers’ day to day experiences. It will eventually become clear as to which interventions the care workers can use while attuning to the meaning of life as perceived by the client and by which methods they can learn to do so. 

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